Competition for seats in Canadian medical schools has driven many Canadians to seek medical education abroad. Systematic barriers make it necessary for internationally educated physicians (IEPs) hoping to practice in Canada to complete postgraduate residencies. To do so, they must transition into new medical education systems. The transitional experiences of internationally educated physicians are not well understood. This phenomenological qualitative study reveals the perspectives of twenty recent graduates from the University of Manitoba Family Medicine residency program. Canadians Studying Abroad constituted the majority of participants. Participant interviews revealed the presence of clinical practice gaps, created by curricular differences in the timing of graduated clinical responsibility between the Canadian and international medical education systems. Participants also shared their experiences of being singled out (visibility and invisibility), rejected and mistreated. They perceived that IEP residents were assigned low status in resident hierarchies. Their experiences are conceptualized as stigmatization.

Many elderly patients visiting the emergency department for minor injuries are not assessed for functional status and experience functional decline 6 months post injury. Identifying such high-risk patients can allow for interventions to prevent or minimize adverse health outcomes including loss of independence. For the purpose of a planned clinical decision rule to identify elderly patients at high risk of functional decline a survey of physicians was conducted. A random sample of 534 Canadian geriatricians, emergency and family physicians was selected with half randomly selected to receive an incentive. A response rate of 57.0% was obtained with 90% of physicians considering a drop in function of at least 2 points on the 28-point OARS ADL scale as clinically significant. A sensitivity of 90% would meet or exceed 90% of physicians' requirements for a clinical decision rule to identify injured seniors at high risk of functional decline 6 months post injury.

Formål:Hensikten med studien er å undersøke hvilken effekt det lovbaserte legefordelingssystemet, som var aktivt i Norge fra 1.1.1999 til 30.6.2013, har hatt, og hvordan ordningen har påvirket utviklingen i legestillinger i primærhelsetjenesten og spesialisthelsetjenesten i Norge. Studien kan gi myndighetene et bedre kunnskapsgrunnlag om statlig regulering av legestillinger. Metode: Forskningsspørsmålene er i hovedsak belyst gjennom kvantitative deskriptive analyser av registerdata og tilgjengelig statistikk. Saksdokumenter og vedtak om tildeling av legestillinger er gjennomgått, og det er gjennomført en kvalitativ analyse av bakgrunnsdokumentene ved innføringen av ordningen. Den teoretiske rammen for studien er folkehelsearbeid, organisasjonsteori og resultatkjeden som et styringsverktøy ved gjennomføring av evalueringer. Resultat: Studienviser at nye legestillinger i primærhelsetjenesten har vært prioritert i hele perioden. Dette kan ha bidratt til å redusere sosiale ulikheter i helse. Antall ubesatte legestillinger er i perioden 1.1.1999 til 30.6.2013 redusert til under 1% av alle legestillinger, både i primærhelsetjenesten og spesialisthelsetjenesten. I samme periode økte antall utdanningsstillinger for leger i spesialisering med 36%. I alt 54% av alle nye legestillinger i spesialisthelsetjenesten er gitt innen nasjonale satsningsområder og prioriterte spesialiteter. Av de nordiske landene har Norge hatt høyest økningen i legedekning pr 1000 innbyggere i allmennlegetjenesten. Konklusjon: Studien viser at den statligereguleringenav nye legestillinger har hatt en effekt, og at et målrettet reguleringssystem kan være et godt administrativt virkemiddel for nasjonal legefordeling og geografisk fordeling av leger. God forankring og bred deltaking er suksesskriterier. / Purpose: This study aimedto investigate the effect of the legally based system for allocating new positions for physiciansunder a policy that wasin effectin Norway between 1 January 1999 and 30 June 2013.The study also aimed to increase understanding of a government-regulated physician distribution system. Method: The primary methodology involved using quantitative descriptive analysis to review registry data and available statistics. Case documents and decisions related to theallocation of physician positions, and case and policy documents related to the original justification for the government-regulated physician distribution systemw ere also reviewed. The theoretical thesis and framework for this study is public health, organization theory, and the "result chain" as a management tool for executing evaluations and deliberations. Result: Theresults of the study show that vacant positions for physicians, both primary and specialists, decreased to less than 1% during the study period. During this same time period, 54% of all new hospital positions were assigned a priority specialty. Positions for specialist education increased 36%. Among the Nordic countries, Norway had the highest increase in coverage by primary care physiciansper 1,000 capita during the past 15 years. Conclusion:The government-regulated physician distribution systemin Norway has been effective. Robustness, consensus building, and broad participation are key conditions and ingredients in the recipe for success. / <p>ISBN 978-91-982282-2-9</p>

Darbo tikslas: Įvertinti asmens sveikatos priežiūros įstaigų pagrindinių žmogiškųjų išteklių būklę, pagrindžiant jų formavimo politikos pokyčių poreikį. Uždaviniai: Įvertinti Lietuvos gydytojų demografinę situaciją ir jų pasiskirstymo regioninius netolygumus, ištirti ligoninėse dirbančių gydytojų rizikos profilį susirgti lėtinėmis neinfekcinėmis ligomis, išanalizuoti ligoninėse dirbančių gydytojų dalyvavimo profilaktiniuose sveikatos patikrinimuose mastą. Tyrimo metodika. Siekiant įvertinti gydytojų demografinę situaciją ir jų regioninį pasiskirstymą, buvo atlikta iš Lietuvos sveikatos informacijos centro, Lietuvos statistikos departamento ir Valstybinės akreditavimo sveikatos priežiūros veiklai tarnybos prie Sveikatos apsaugos ministerijos gautų oficialių duomenų statistinė analizė. Gydytojų sveikatos būklės įvertinimui buvo pasirinkta po vieną ligoninę iš didmiesčio ir rajono (Vilniaus regione – Vilniaus miesto ir Ukmergės miesto ligonė, Kauno regione – Kauno miesto ir Marijampolės ligoninė). Visiems tose ligoninėse dirbantiems gydytojams buvo išdalintos anketos, suskirstytos į šešias dalis: I dalis – asmens duomenys ir darbinė veikla, II – pasitenkinimas darbu, III – klausimai apie sveikatą, IV – klausimai apie profilaktinius sveikatos patikrinimus, V – klausimai apie gyvenseną ir VI – nuomonė apie sveikatos priežiūrą. Dalyvauti tyrime buvo pakviesti visi tyrimo dieną dirbantys gydytojai. Anketinėje apklausoje dalyvavo 281 gydytojas (76 proc.). Sveikatos patikrinime... [toliau žr. visą tekstą] / Aim of the study: To evaluate the main human resources’ status in the health care institutions in support of their policy-making need to change. Objectives: To evaluate demographic situation of Lithuanian physicians and regional inequalities in the distribution of physicians; to assess the risk profile of chronic noncommunicable diseases of hospital-employed physicians; to analyse participation of hospital-employed physicians in screening programmes. Material and methods. The official statistical data obtained from Lithuanian Health Information Centre, Lithuanian Department of Statistics and the State Health Care Accreditation Agency under the Ministry of Health were used for evaluation of demographic situation of physicians and their regional distribution. The assessment of health status of physicians was carried out in four randomly selected hospitals from Vilnius and Kaunas regions. Two hospitals were selected from Vilnius and Kaunas cities, one hospital - from Ukmergė municipality and one hospital - from Marijampolė municipality. The questionnaire, which was distributed to physicians, consisted from six parts: I - personal data, and working activities, II - job satisfaction, III – health status, IV - preventive health check-up, V – health behaviours, and VI - opinion of health care. All physicians who were working in the hospital on the day of survey were invited to participate. Questionnaires were filled in by 281 physicians (response rate was 76%), and 242 physicians... [to full text]

The New South Wales Medical Board established a Health Programme for the assessment and rehabilitation of doctors whose clinical performance was impaired by alcohol or psychoactive substance use, mental or physical illness. This programme was developed to be individualized to the needs of each registrant. The present study has three aims: 1. To describe those doctors who participated in the Board???s Health Programme. 2. To chart the duration of involvement of these doctors through the programme. 3. To examine the outcomes associated with this programme. The study is based on the prospective cohort of all 181 impaired doctors who participated in the Health Programme between July 1st 1993 and April 30th 2001. Information on each registrant was collected at the time of the initial assessment and at each review conducted as part of the programme. Additional qualitative data was also collected and supplemented by a file audit conducted in August and September 2001. One hundred and eighty-one doctors were prospectively monitored as part of this study. The largest source of impairment was psychiatric illness (45.3%), 77% of the doctors were male. The average age of the cohort was 41.6 (sd 11.1) years. Impaired doctors were more likely to be working in emergency medicine or psychiatry and be based in a rural area. Of those who had finished their involvement in the programme, successful graduates participated for a mean of 38.2 (sd 22.3) months. In general outcomes of involvement were positive, 64 of 113 (56.6%) of doctors successfully graduated from the programme. One hundred and ten of 168 (65.5%) improved during the period of their involvement and 111 of 126 (88.1%) were working in medicine. Five, 2.8% of the participants died during the period of this study. Measures of registrant insight and support tended to increase during the period of involvement with the Health Programme. Future studies will need to establish evidence for the most appropriate interventions with impaired doctors. This process would be strengthened by the collection of standardized data across intervention programmes, supplemented with functional assessments and the collection of qualitative data.

Diss. (sammanfattning) Linköping : Univ., 2005. / Härtill 5 uppsatser.

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 4 uppsatser.

Thesis (Ph.D.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Engineering Management, Department of Mechanical Engineering. Title from pdf file main screen (viewed on October 23, 2009). Includes bibliographical references.

Thesis (doctoral)--Swinburne University of Technology, 2006. / Title from PDF title page (viewed on Nov. 30, 2006). Includes bibliographical references (p. 177-188).

Thesis (Ph. D.)--University of Texas Health Science Center at Houston, School of Public Health, 1994. / Typescript. Includes bibliographical references (leaves 143-154).